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A change in perspective

Note: This article was first published by Doctors Nova Scotia Magazine.

I have been in medical practice for more than 30 years. I have seen thousands of patients and have always considered empathy to be one of my strengths. Although I was not experiencing what my patients were going through, I felt that I understood the challenges faced by someone in our health care system.

That changed in March 2015. I had a lower gastrointestinal bleed that necessitated my emergency admission to hospital. My “physician brain” was calmly analyzing my presentation and considering the differential diagnoses, while my “patient brain” was in a panic – “I have a huge and important lecture to give tomorrow. Who is going to cover me? What am I going to do about my dog? I have a new job starting in three weeks, so this cannot be happening.” I could not cope with the inconvenience of being sick.

As it turns out, I had 20 cm of ischemic bowel, probably from longstanding intermittent twisted or prolapsed gut. My decision was clear: Have a hemicolectomy (removing the right side of the colon and attaching the small intestine to the remaining portion of the colon) and have it soon, to prevent ongoing trouble.

My focus was on getting my job covered, making sure that the system would continue to run smoothly in my absence, and getting back to work as soon as I could. That was my priority then. It is not my priority now.

After surgery, things did not go quite as expected. I ended up with a temporary ileostomy (opening in your abdomen that allows waste or urine to leave your body) as a precaution. I was in hospital for 14 days instead of the predicted seven. I did not follow the usual care plan and I learned how important it is to be one’s own advocate. I worried about those patients and families who did not have the same knowledge or support that I did, and I wondered how they would have fared in the same situation.

I received superb medical care. However, it was important for me, the patient, to have a voice. I felt vulnerable. In spite of my years of experience on the other side of the table, I was uncertain, scared and even a little depressed. “Can I lift? How should my incision look? Can I live with an ostomy, even temporarily? How did my life prior to all this contribute to my own medical condition?”

I am pleased to report that I am now well, but I am changed. I believe strongly in the need for work-life integration and I need to set the limits on how my work affects my well-being; I am doing so doggedly. I also have a new appreciation for the patient journey. My new mission is to make the entire patient experience, from first to final encounter, one that never loses sight of the patient’s experience during each moment of care.

I urge you to reflect on your lives and what should be important to you, your own health and your practice. We will all be patients someday.

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